How to deliver a baby at home (emergency situation)
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Basic Emergency Delivery Instructions
Delivering a baby at home, unassisted, can cause fear in the most courageous heart, but really, it needn't. Birth is a very natural process and, in most cases, not a medical emergency. Unplanned homebirth, even unplanned CAR birth, happens all the time with happy results all around.
- Calm yourself. Take deep breaths. You can do this!If you are outwardly calm the mom will be, too. Being calm will make her delivery much easier as her muscles will be relaxed and she will be working with her body rather than against it.
- Calm the mom. Tell her it will be o.k...it will! During hard labor, especially transition, it is normal for her to feel panicky, anxious, and overwhelmed. In fact seeing these emotions should alert you that birth is imminent.
- If you have time get her on a clean surface, clean towels, clean sheets, etc. Being on the floor will be better than a bed or softer surface.
- Try to get her up in a squatting position. This will shorten the birth canal and gravity will work in her favor.
- Remind her to breath deeply and push when she feels like pushing. She will make loud noises and groans, maybe even scream. This is more about the work and effort involved than the pain, although it is painful.
- When you see the top of the baby's head, this is called crowning. DO NOT TRAY TO PULL THE BABY OUT AT ANY TIME. Reassure the mom that the baby is about to be born in the next few pushes.
- As the perineum bulges gently support it with your hand to minimize tearing.
- Gently cradle the baby's head and guide it out of the birth canal with the pushes of the mom's body. It will usually turn to the side as it emerges.
- As soon as the baby's head is out clear it's nose and mouth of fluids by stroking downwards on the nose and mouth gently, or using a bulb syringe, gently.
- It is not unusual for a cord to be around a baby's neck. If you can slip a finger between the cord and the neck try to slip the cord over the baby's head but if you can't do it just leave it. Do not cut the cord!!
- The baby's head will come out then the first shoulder, then the second, then the rest will slip out quickly.
- Hold the baby securely with the head at a 45 degree angle to allow the fluids to drain from the nose and mouth. The lower part of the body, including the feet should be above the head. Do not hold the baby by it's feet though.
- DO NOT PULL OT CUT THE UMBILICAL CORD!!
- If the cord is long enough have the mom lay with the baby on her chest and cover both with a warm blanket. Keep mom and baby warm.
- If the mom is willing to nurse the baby immediately it is best that she do so. This will help the body to expel the placenta and stops bleeding by releasing oxytocin in to the body.
- Allow the placenta to be expelled on it's own. DO not pull it out, to do so could cause severe, and life threatening, bleeding. Save it, the doctor or midwife will want to examine it.
- If you are awaiting the arrival of a doctor, get the mom a drink of orange juice or herbal tea and rejoice with her while you wait.
- If no doctor is able to get there, wait until the cord stops pulsing completely. There is no need to hurry. Tie it with clean thread about 4 inch from the baby, then tie it off about 4 inches away from the first tie. Cut between the two threads.
- Massage the mom's abdomen every 15 minutes or so, to help the uterus return to size and bleeding to stop.
- Good job!
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How to Deliver A Baby in a Taxi
Possible Problems
Once in awhile things do go differently than planned. If this happen, STAY CALM!
- If the shoulders seem stuck- try pushing down just above the mom's pubic hair. If this does not work try to get her in a hands and knees position. Sometimes this will help a stuck shoulder slip past the pelvic bones. Never pull on baby!
- Babies can be bluish when born. After a few breaths it will pink up. If it doesn't breath immediately or seems listless you can try gently slapping the soles of it's feet to get a good, deep cry.
- If the baby is not breathing do mouth to mouth gently by blowing a few breaths (gently!) into the baby's mouth.
- If the baby is breech (butt first) allow the birth to progress as above. You might try putting a finger along the baby to push the vaginal wall away from the face during birth.
- During the birth process the perineum will bulge alot! Someone once called my midwife in a panic because they believed that somehow the baby had moved and was coming out the mother's anus. This won't happen. Expect everything to look odd.
The Disclaimer
This is not meant as medical advice, only as a basic guide to use in an unexpected homebirth. Nothing can take the place of a good midwife (or doctor) in these situations.
However, birth is hard to control and things happen at unforeseen times and odd moments! Be calm, be ready, and be optimistic. Of my eight children, six were born at home. The homebirths were wonderful experiences. Birth is natural, although modern medical science would try to convince us otherwise.
Books on Homebirth
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Unassisted Homebirth: An Act of Love
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EMPOWERED TO BIRTH NATURALLY: One Woman's Journey to Homebirth
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Comments
First cousins- normally there is a chance that there will be some difficulty in the child.
oh okay. thanx.
Think it is probably illegal in some countries, but my best friend and his 5 siblings Mom and Dad are cousins, and they have no wings, nor an extra arm in the forehead.
Good post and nicely written, Visit my new blog
Marye! I hope it will never be necessary for me to help out in a birth. I'm not sure I could handle the responsibility. On the other hand holding a tiny sprout again would be nice. (I need to discuss that with my daughter and son-in-law...)
great HUB as always
regards Zsuzsy
Very well explained! I wrote about this same topic but from a more personal perspective based on my experience delivering my own baby!
Sounds good Marye. Do you know how many woman in general have to give birth by themselves at home?
Gravity can do wonders! My friend just gave birth at home (somewhat accidentally), and she was standing up! Great hub.
Futures daddy's should watch this so that they would know what to do in case
Excellent and very helpful.
What if the baby is a few weeks premature? I may have to deliver a baby for a refugee with no papers or money. Please help. I've not done this before.
Maria,
A premature baby needs alot of care. Hospitals cannot turn away patients on any basis and you should try to get her there if possible.
I hope my boyfriend do not have to deliver my baby(lol)
Hey Maria,
Actually, a baby is considered "term" at 37 weeks...so if your refugee Mom's baby comes "a few weeks early", it is likely that prematurity is not going to be her biggest problem. Of greater concern would be the fact that she is a refugee...so what has she been eating? What is her stress level currently? How is her general health? Is she underweight to begin with? Does she have any other health concerns pre-dating her pregnancy?
These kinds of situations can turn out just fine, or they can go drastically sideways in a hurry. Medical care is a good idea for her and her baby, and Marye is right in that a public hospital cannt turn away a woman in labor. Even private hospitals have to provide basic supportive care while transferring her to a public hospital. She won't be denied care...and in her case such care could be vital.
I hope you will post the outcome so we know how this Mom and her wee one are doing now.
Blessings,LorrieB.
One other thought...
In my experience, shoulder dystocias ("stuck shoulders") are not all that uncommon. The problem varies from being very slight and easily resolved with no intervention, to severe dystocia requiring pretty drastic measures to get Baby's shoulders unimpinged and delivered. However, I would not suggest suprapubic pressure as a FIRST avenue of trying to deal with this problem, because this can often simply further wedge Baby's shoulder behind the pubic bone and cause pain stress to Baby. First-line measures I usually employed were to lay Mom flat on her back and pull both of her knees upward toward her chest, which will usually release the front shoulder from behind the pubic bone. If this fails, and you will know very quickly if it's going to work or not, then I move Mom onto her hands and knees. This not only is usually effective in releasing the stuck shoulder, but in the event that the dystocia turns out to be severe and require manipulation of the baby in order to free the shoulders, the all-fours position opens the pelvis and makes it much easier for a midwife or physician to manually move the baby and attempt to dislodge the shoulders.Fortunately, when a baby comes so quickly that Mom cannot get to a facility to give birth or her care-provider cannot reach her if she plans a home delivery, shoulder dystocia is not usually an issue. One common tip-off of shoulder dystocia is very slow progress once pushing begins, especially once the top of Baby's head becomes visible. Once the top of the head is visible, progress should be steady and birth should occur relatively soon. If it does not, then you might suspect either a shoulder dystocia problem or perhaps a nuchal cord too tight to allow the baby to descend further. Both situations set Baby up for distress, so obviously should be dealt with.Just some food for thought.Thanks for the great hub, Marye!
Blessings,Lorrie
Interesting. Not cutting the cord until all is over seems to make a perfect sense, however they do cut it as soon as baby is out in the hospitals. Do you know why?
Lorrie thanks! that was great input!
Misha...sure I do...the doc can get to the next patient (or his golf game) quicker. In hospital obstetrics it is more about convenience that anything.
Guess you are right Marye. This brings up another question - do we have at least a remote idea on how this premature cut affects baby mental and physical development? Immune system and future allergies for example?
Oh, and video is no longer available btw. I guess it was too graphic for google, as any real life video...
Oh yes, there are numerous possible ramifications to Baby with hasty cord-cutting! Most are related to benefits lost when cord-cutting is not DELAYED. For example: Delaying cord-clamping/cutting allows Baby to receive oxygenated blood for a slightly longer period of time after birth while his/her little lungs expand and begin transferring oxygen to the bloodstream on his/her own. Obviously if the cord is clamped/cut immediately, Baby misses out on the little "oxygen bridge". In a perfect baby with no stress at birth, this might make no difference at all..but in a stressed baby who takes a minute to kick-start on his own, delaying clamping/cutting can make the difference in how quickly and how thoroughly Baby rebounds and starts breathing well on his/her own. Here are a few more reasons to wait, in the words of seasoned Midwife Ronnie Falcao:Leaving the cord to pulse does "no harm" and therefore should be encouraged. If you can think about what Nature intended, our ancestors way back before scissors and clamps were invented must have had to wait to deal with the cord/placenta until the placenta was birthed. They probably chewed it, ground it with rocks, or burned it through with hot sticks from the fire. The little teeth on the clamps indicate the traumatizing of the vessels is necessary to quell bleeding. [Editor's Note - Some midwives say that if you delay cutting the cord until an hour or so after the birth, there will be no bleeding at all from the stump.] Leaving the cord to pulse slows down the "fire drill" energy that many birth attendants get into after the baby is born. Leaving off the busyness of midwifery for a half hour allows the mother and baby undisturbed bonding time without a "project " going on i.e. the cord cutting instructions, explanations, jokes, etc. The father, too , is undisturbed and able to enjoy this "high" time without focusing on a job at hand. Educator Joseph Chilton Pierce in his book "Magical Child" makes ref to studies that were done on primates who gave birth in captivity and had early cord clamping. Autopsies of the primates showed that early cord clamping produced unusual lesions in the brains of the animals. These same lesions were also found in the brains of human infants when autopsied. In Rh neg women, many people believe that it is the clamping of a pulsing cord that causes the blood of the baby to transfuse into the blood stream of the mother causing sensitization problems. Robert S Mendelsohn, M.D., in his book "How to Have a Healthy Child. . . In Spite of Your Doctor" blames the whole Rh neg problem on too quick clamping of the cord. Especially in Rh neg mothers I urge midwives to wait until the placenta is out before thinking about cord clamping. I think it is interesting that scientists are now discovering that umbilical cord blood is full of valuable T-cells which have cancer fighting properties. A whole industry has sprung up to have this precious blood extracted from the placenta, put in a cooler with dry ice, and taken to a special storage facility to be ready in case the child gets cancer at some time in the future. This is human insanity of the first order. That blood is designed by Nature to go into that child's body at birth, not 30 yrs later! We need to acknowledge that there are things about the newborn circulation and blood composition that we just don't know and we need to bet that Mother Nature had things figured out pretty well for us to survive this long. Maybe the supposed need for Vitamin K in the newborn comes out of early cord clamping?
I can add nothing more that that, hope it helps.Blessings!Lorrie B.
Some of the things that are done in hospitals like cutting the cord immediately are only done because it is easier and quicker for the staff or doctor, not because it is necessarily better for the Mum or baby.
The most important thing to do, is allow the Mum to stay as calm and relaxed as possible it is MUCH easier for relaxed muscles to stretch as far as they need to when the person it relaxed.
When a baby is 'stuck' I use a couple of little Bowen moves to release the pelvis, but anyone can do this one: take a matchstick or something similar and apply in small, gentle circular movements to the crease on the outside of the little toe.
This is an ancient midwives trick from Asia with no harm to mother or child, and this helps to open up the meridian to the pelvis and uterus and really can work when all else fails.
When all else fails, putting a finger into the birth canal and gently hooking it under the armpit of the baby to pop it's shoulder out (ONLY IN DIRE EMERGENCY) can move a birth forward and save the life of mum and baby. It can however result in dislocation of the shoulder and should really be used by a nurse, midwife or doctor, unless there is no other recourse.
by the way a pretty good take on birthing, good Hub!
Useful guidance for the moms.
Hey Marye,
This is exactly what I am searching for. Thanks for such a great article. I just think that hospitals are somehow too controlling. They want you cooperate with them rather than helping you.
Thank you very much again!
George
Our first child was a (planned ) home birth. It was by far the best of all 4 of our children's birth. We had an exceptional midwife who had to assistants and my mom ( a registered nurse) in attendance. It was beautiful. My second child was born in the hospital. As the baby was crowning (just starting to show) the nurse freaked out. I had to be there to catch the baby, but at literallythe last second, the doctor pushed me away and caught my daughter in the same movement. That whole visit was a fiasco. Great hub, it really is not scary if you are armed with lots of info.
Hi I am the father of a very proud daughter we live on a farm far from any town or doctors your info helped me and my wife to deliver the most beutiful daughter.
We love you for that
How informative. Now I'm ready to assist others, just in case.
that was digusting but radical
We narrowly avoided a home birth...phew
Tremendous and very informative hub. My nephew has delivered two of his eleven kids at home.
Robert Putz Ballard
Im only 14 but i would like to be a midwife when i'm older. Plus i have a question: Is it any more dangerous to deliver a baby at home (with a trained and licsensed midwife) than it is to give birth in a hospital?
- just wondering
Celene says:
2 years ago
Just wondering , but , can cousins be married and have healthy children?